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Bayla Ostrach

Research Scientist, Mountain Area Health Education Center and Assistant Professor of Family Medicine; Affiliated Faculty, Medical Anthropology and Cross-Cultural Practice, Boston University School of Medicine

Areas of Expertise:

Health Care Reform

Reproductive Health

Social Issues

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About Bayla

Ostrach, MA, PhD, an applied medical anthropologist, is a Research Scientist at the Mountain Area Health Education Center in Asheville, North Carolina. She is a Visiting Research Scholar-in-Residence in the Department of Social Sciences at the University of North Carolina-Asheville while maintaining her faculty appointment as an Assistant Professor of Family Medicine and Affiliate Faculty in the Medical Anthropology & Cross-Cultural Practice program at Boston University School of Medicine. Ostrach is the author of Health Policy in a Time of Crisis: Abortion, Austerity, and Access (Routledge Press) and a co-editor of a new two-volume set on stigma syndemics: Foundations of BioSocial Health; New Directions in BioSocial Health (Rowman & Littlefield).

The social stigma attached to adolescent childbearing is biologized within biomedical pregnancy and delivery care. Social stigma is embodied as psychosocial stress, and drives medical decision-making on women's behalf in ways that produce unnecessarily damaging outcomes. The specific biological-biological interaction between the (pathologized) pregnant teen body and iatrogenic early inductions, c-sections, and other interventions increase risks of negative maternal-infant outcomes. Presents how the ageism inherent in teen pregnancy stigma intersects with classism, racism, and other systems of oppression to intensify the structural-biological-biological interactions that worsen outcomes.

Highlights the diverse ways in which various stigmatized health conditions interact with each other and with social inequalities and stigma, to form syndemics. Addresses how stigma translates from a social condition to various biological conditions.

Presents a syndemic model of abortion stigma–pathways of interaction involving 1) abortion-related stigma, which produces, facilitates, and perpetuates interactions between 2) socially pathologized pregnancies ending or intended to end in abortion, making abortion a biomedical aspect of a socially pathologized pregnancy, and 3) the deleterious health consequences of constrained abortion care interacting with a pathologized pregnancy. Together, these biological, biomedical, and structural interactions threaten reproductive health and lives.

Explores new directions in syndemics research– revealing what syndemics theory can illuminate about, in particular, stigma-driven reproductive syndemics, carceral syndemics, and syndemics of poverty and malnutrition, as well as oral health syndemics. Links social stigmatization, structural conditions, and how these societal forces drive biological and disease interactions affecting human health, in areas not previously explored through these lenses.

Presents follow-up data from a study conducted a year after the policy change described in previous research, showing that even with a successful policy change, reforms are not always permanent or adequate.

Health Policy in a Time of Crisis: Abortion, Austerity and Access (Routledge Press, 2017).

Examines the disparities experienced by immigrant and other women, documenting the diverse approaches adopted to overcome obstacles to care in a publicly funded health system. Uses accounts from both providers and women seeking care to illuminate what the Catalan healthcare system, during a period of economic crisis and austerity, reveals about access to care and reproductive governance.